CASE STUDY: Wilma is an 84-year-old widow who lives independently alone, in her North Adelaide family home. Her two children and grandchildren live interstate and have not visited since January 2020 due to border closures related to COVID-19. She is socially active with friends, plays cards twice a week, choir practice twice a week and attends church on Sundays. Several weeks ago, Wilma was having lunch with her friends and found it difficult to form her words, her friends were unable to understand what she was saying and shortly after this she collapsed in her chair, unable to respond to verbal stimuli. An ambulance was called, and Wilma was taken to the hospital. • On arrival to the hospital, Wilma’s observations: P 134, RR 26, BP 165/95, T 37.6, SpO2 92% on room air, GCS of 12. • A CT scan provided a diagnosis of CVA. • Wilma’s past medical history includes: Salpingo-oopherectomy and Hysterectomy – 23 years ago; NIDDM - 15 years; AF; GORD; Smoker – 10/day; Hypertension; Hypercholesterolaemia; MI Wilma was admitted to the neurological ward with the following assessment information: GCS of 13, left sided hemiplaegia, expressive dysphasia, dysphagia and blurred vision. A review by the speech pathologist and physiotherapist was arranged. Ten days later Wilma was transferred to a rehabilitation hospital with residual dysphasia, left sided hemiplegia. Ongoing medications include: Apixaban 5 mg PO daily Ezetimibe 10 mg PO daily Digoxin 125 mcg PO daily Perindopril 2 mg PO daily Simvastatin 40 mg PO daily Amlodipine 10 mg PO daily 1. Identify the most likely aetiology of Wilma’s CVA • Explain how and why this can lead to a CVA from a pathophysiological perspective. • Include the pathophysiology of Wilma’s CVA. • In other words, discuss the pathogenesis of the most likely cause and how it can lead to CVA in relation to Wilma’s case.

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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CASE STUDY: Wilma is an 84-year-old widow who lives independently alone, in her North Adelaide family home. Her two children and grandchildren live interstate and have not visited since January 2020 due to border closures related to COVID-19. She is socially active with friends, plays cards twice a week, choir practice twice a week and attends church on Sundays. Several weeks ago, Wilma was having lunch with her friends and found it difficult to form her words, her friends were unable to understand what she was saying and shortly after this she collapsed in her chair, unable to respond to verbal stimuli. An ambulance was called, and Wilma was taken to the hospital. • On arrival to the hospital, Wilma’s observations: P 134, RR 26, BP 165/95, T 37.6, SpO2 92% on room air, GCS of 12. • A CT scan provided a diagnosis of CVA. • Wilma’s past medical history includes: Salpingo-oopherectomy and Hysterectomy – 23 years ago; NIDDM - 15 years; AF; GORD; Smoker – 10/day; Hypertension; Hypercholesterolaemia; MI Wilma was admitted to the neurological ward with the following assessment information: GCS of 13, left sided hemiplaegia, expressive dysphasia, dysphagia and blurred vision. A review by the speech pathologist and physiotherapist was arranged. Ten days later Wilma was transferred to a rehabilitation hospital with residual dysphasia, left sided hemiplegia. Ongoing medications include: Apixaban 5 mg PO daily Ezetimibe 10 mg PO daily Digoxin 125 mcg PO daily Perindopril 2 mg PO daily Simvastatin 40 mg PO daily Amlodipine 10 mg PO daily 1. Identify the most likely aetiology of Wilma’s CVA • Explain how and why this can lead to a CVA from a pathophysiological perspective. • Include the pathophysiology of Wilma’s CVA. • In other words, discuss the pathogenesis of the most likely cause and how it can lead to CVA in relation to Wilma’s case.

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